BVA9503570
DOCKET NO. 93-06 806 ) DATE
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On appeal from the decision of the
Department of Veterans Affairs Regional Office in Houston, Texas
THE ISSUE
Entitlement to an increased evaluation for an conversion
reaction, currently rated as 30 percent disabling.
REPRESENTATION
Appellant represented by: Texas Veterans Commission
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
M. Auer, Counsel
REMAND
The veteran served on active duty from January 1942 to December
1944.
This appeal arises from an April 1989 rating decision of the
Department of Veterans Affairs (VA), Houston, Texas, Regional
Office (RO). In that decision, the RO denied an increased rating
for the veteran's service-connected conversion reaction. By
rating decision of July 1991, the RO a 30 percent rating for the
veteran's service-connected conversion reaction was granted.
The veteran was examined by the VA in June 1991. The examiner
reported that he did not have access to the veteran's claims
file. Following his examination, the diagnoses included
generalized anxiety disorder, moderately severe and organic
mental syndrome, minimal severity. The examiner specifically
remarked that, in absence of the veteran's claims file, no
opinion could be performed regarding any possible etiological
relationship between the condition diagnosed as conversion
disorder during his military service and the psychiatric disorder
for which he is now receiving treatment. Additionally, the Board
of Veterans' Appeals (Board) notes that the examiner did not
provide a Global Assessment of Functioning (GAF) scale code or
otherwise indicate the degree to which the psychiatric disorder
results in reduction in initiative, flexibility, efficiency and
reliability levels. See Massey v. Brown, No. 93-135
(U.S.Vet.App. Dec. 6, 1994).
In a January 1993 statement, the veteran indicated that he had
been told that he had Parkinson's disease by someone at the VA in
Beaumont, Texas. When examined by the VA in June 1991, it was
observed that he was visible tremulous. It was noted that the
tremor constituted the veteran's primary complaint and the most
prominent symptom of a generalized anxiety disorder.
In view of the above, the Board finds that further development is
warranted before a final decision in this appeal. Accordingly,
the claim is REMANDED for the following actions:
1. The RO should contact the veteran and
ask him to furnish the names and addresses
of all private medical personnel and
facilities from whom he has received
treatment for the disability at issue since
June 1991. After obtaining the necessary
authorization from the veteran, the RO
should obtain available records from the
named sources, and permanently associate all
such records with the veteran's claims
folder.
2. The RO should obtain and associate with
the claims folder any available treatment
records from the VA hospitals or medical
centers where the veteran has received
treatment since August 1992. Care should
be taken by the RO so that duplicate records
are not placed in the claims file.
3. Following the above development, a
special neurological examination of the
veteran should be scheduled for the purpose
of determining the nature and extent of any
current neurological disorder. The examiner
should review the claims folder prior to the
examination and express an opinion as to the
probable etiology and date of onset of any
neurological disorder. All necessary tests
should be performed.
4. Following completion of the above
development, the veteran should be accorded
a VA psychiatric examination to determine
the nature and severity of his psychiatric
disorder. The claims folder must be made
available to the examiner prior to the
evaluation so that the examiner may review
the pertinent historical data contained
therein. The examiner should utilize the
pertinent data in the claims folder in order
to obtain a true picture of the progress of
the veteran's psychiatric disorder. The
psychiatrist should conduct any psycho-
logical testing deemed pertinent in making a
complete diagnostic evaluation. Based upon
a review of the record and the examination,
the examiner specifically is requested to
offer an opinion as to the relationship, if
any, between any tremors experienced by the
veteran (which are not attributable to a
distinct neurological disorder) and his
service-connected psychiatric condition.
The physician should also provide a Global
Assessment of Functioning (GAF) scale code
and discuss the nature and meaning of the
numerical value assigned. In addition, the
examiner should discuss the veteran's
ability to perform substantially gainful
employment and the factors attributable to
the service-connected psychiatric disorder
that limit his employment opportunities.
The complete rationale for all opinions
expressed should be provided.
5. After the above actions have been
completed, the case should again be reviewed
by the RO, to include consideration of the
issue of entitlement to service connection
for a neurological disorder, if appropriate.
The rating decision should reflect
consideration of 38 C.F.R. §§ 3.321(b)(1)
and 4.16 (1994) (relating to the assignment
of an extra-schedular disability
evaluation).
If his claim remains denied, the RO must advise the veteran and
his representative that, to obtain appellate review of any issue
adjudicated but not presently on appeal, a notice of disagreement
and substantive appeal must be filed. After provision of a
reasonable period of time for response, if necessary, the veteran
and his representative should be provided with a supplemental
statement of the case, with respect to all issues properly
developed for appellate review, that includes any additional
pertinent law and regulations and a full discussion of the
evidence in this case. The appropriate response time should be
allowed. The case should then be returned to the Board, if in
order, after compliance with all regulatory appellate procedures.
The RO specifically is requested to complete all necessary
actions as expeditiously as possible.
By its REMAND, the Board does not intimate any opinion as to the
ultimate disposition of this case, either favorable or
unfavorable, at this time. No action is required of the veteran
until notified.
JACQUELINE E. MONROE
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___
(1994), permits a proceeding instituted before the Board to be
assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the Board
on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1994).